Holding Hope Q&A

Complementary medicine, including naturopathy, can play a role in a collaborative healthcare approach for longstanding eating disorders. Integrating various therapeutic options allows for a more holistic treatment plan that considers the individual's physical, emotional, and spiritual needs. The emphasis on a person-centred care plan within the palliative care framework supports the inclusion of diverse treatment modalities that align with the individual's preferences and goals for care (Holding Hope, p. 30). 

A harm reduction approach focuses on minimising the negative consequences associated with eating disorders without necessarily aiming for complete recovery. This can include strategies to reduce the risk of medical complications and improve the individual's quality of life. In contrast, a palliative care approach is broader, addressing not only the physical symptoms but also the emotional, social, and spiritual aspects of the individual's condition. Palliative care prioritises comfort and quality of life, often when recovery is not the primary goal (Holding Hope, pp. 23-25). 

The National Disability Insurance Scheme (NDIS) can provide funding and support for individuals with longstanding eating disorders, particularly those with significant and enduring impacts on their daily lives.

Full question: Where do people get this care and support from? Where do people go when a palliative care approach is recommended? Acute hospitals won't take these people, and eating disorder hospitals only have a one-size-fits-all approach and don't take a harm reduction approach. 

are and support can come from various sources, including community-based services, specialised eating disorder clinics, and multidisciplinary healthcare teams. When a palliative care approach is recommended, it is essential to engage with palliative care services that can offer home-based care, community hospice services, or support through specialised palliative care units. Collaboration between healthcare providers is crucial to ensure that individuals receive comprehensive and compassionate care tailored to their unique needs (Holding Hope, pp. 26-28, 34). 

This statement underscores the importance of recognising that treatment approaches must be adaptable and responsive to the individual needs of people with eating disorders. When standard treatments do not yield the desired outcomes, it is not the individuals who have failed but rather the treatment approaches that need to be re-evaluated and adjusted. Emphasising person-centred care and flexible, compassionate approaches can help ensure that treatment supports the individual's overall well-being and quality of life (Holding Hope, p. 20). 

The full document of 'Holding Hope: Exploring Compassionate & Holistic Care Pathways for Longstanding Eating Disorders' is available on the National Eating Disorders Collaboration (NEDC) website. You can access the complete discussion paper and additional resources by visiting NEDC's Holding Hope page (Holding Hope, p. 2). 

Will the Holding Hope initiative facilitate innovative/novel science/trial/pilot evidenced therapies like TBT-S? 

The 'Holding Hope' initiative aims to foster innovation and acceptance of new and emerging treatments by advocating for a flexible and inclusive approach to care. By emphasising the importance of compassionate and holistic care pathways, the initiative supports the exploration and integration of diverse therapeutic modalities, including emerging and evidence-informed treatments like TBT-S. Collaborative efforts among clinicians, researchers, and individuals with lived experience can help reduce resistance and promote the adoption of innovative therapies that address the unique needs of people with longstanding eating disorders (Holding Hope, pp. 23-25, 37). 

From a clinical perspective, are we not remiss when we blur our focus from a lens of recovery to one of agency which could ultimately be life-shortening?

The ethical considerations surrounding the transition from a recovery-focused approach to one that emphasises agency and quality of life are complex. It is crucial to balance respecting the individual's autonomy and providing compassionate care. The 'Holding Hope' discussion paper addresses these ethical dilemmas by advocating for a person-centred approach that honours the individual's preferences and goals for care, while also recognising the importance of ongoing support and hope for recovery. Ensuring informed consent and involving the individual in decision-making processes are key components of ethical care (Holding Hope, pp. 31-33). 

Decision-making capacity is a critical aspect of providing care for individuals with longstanding eating disorders. The 'Holding Hope' discussion paper highlights the importance of assessing decision-making capacity to ensure that individuals are fully informed and capable of making choices about their care. This includes understanding the risks and benefits of different treatment options and respecting the individual's autonomy and preferences. Regular assessment and clear communication between healthcare providers, individuals, and their families are essential to support informed decision-making (Holding Hope, pp. 31-33). 

Thank you for your positive feedback. We agree that it is crucial to continue these conversations to improve care and support for individuals with longstanding eating disorders. Ongoing dialogue and collaboration among all stakeholders are key to driving meaningful change and ensuring that everyone affected receives the compassionate care they need (Holding Hope, pp. 37-38). 

Addressing the state of care in all parts of Australia requires a multifaceted approach, starting with increasing awareness and access to palliative care services. Collaboration with local healthcare providers, advocacy for improved resources, and education about the benefits and availability of palliative care can help bridge the gap in initial care. Establishing a network of support and leveraging existing resources within the community can provide a starting point for individuals and their families seeking palliative care options (Holding Hope, pp. 34-35). 

Engaging with general public sector mental health clinicians involves raising awareness about the importance and benefits of palliative care for longstanding eating disorders. This can be achieved through professional development opportunities, workshops, and seminars that highlight the findings and recommendations of the 'Holding Hope' discussion paper. Collaborating with professional organisations and leveraging existing networks can also facilitate broader discussions and promote the integration of palliative care principles into mental health practice (Holding Hope, pp. 37-38). 

Clinicians seeking colleagues who are open to harm reduction approaches can connect through professional networks, forums, and organisations dedicated to eating disorder treatment and palliative care. The National Eating Disorders Collaboration (NEDC) and similar organisations can provide resources and directories to help identify other professionals working in this space. Engaging in interdisciplinary meetings and conferences can also foster connections and facilitate the exchange of ideas and best practices (Holding Hope, pp. 37-38).

Establishing permission to take a quality of life, harm reduction, or palliative approach involves building a supportive network of colleagues and engaging in open dialogue with your professional community. Seeking guidance from experienced professionals, participating in professional development opportunities, and advocating for the adoption of compassionate care principles within your organisation can help reinforce the legitimacy of these approaches. Additionally, referencing the 'Holding Hope' discussion paper and its recommendations can provide a solid foundation for justifying these care strategies (Holding Hope, pp. 31-33, 37).

Individuals interested in contributing to these discussions can engage with the National Eating Disorders Collaboration (NEDC) and other relevant organisations. Participating in forums, attending conferences, and joining professional networks dedicated to eating disorder treatment and palliative care are excellent ways to get involved. Additionally, sharing personal experiences, insights, and expertise can help shape future initiatives and policies (Holding Hope, p. 2). 

Thank you for your thoughtful comment. We are committed to ensuring that the 'Holding Hope' discussion paper reflects the complexity of lived and living experiences and promotes person-led, compassionate care pathways. Your recognition of this work underscores the importance of our collective efforts to improve care and support for those affected by longstanding eating disorders (Holding Hope, pp. 37-38).

We understand your concern. The adoption of new approaches and care pathways requires time, education, and advocacy. By continuing to raise awareness, providing training, and demonstrating the effectiveness of compassionate, person-centred care, we can work towards greater acceptance and implementation within the workforce. Collective efforts from all stakeholders are essential to drive this change (Holding Hope, pp. 37-38).